The Rehabilitation Research and Development Center of the Pale Alto VA teamed up with the Stanford University Department of Mechanical Engineering in 1978 under the leadership of Prof. L. Leifer to start a rehabilitation robotics program that has benefited from five major funding cycles to date. Many lessons were learned along the way, mostly through the interactions between engineering staff, clinical staff, persons with high level quadriplegia who served as test subjects and their families and attendants. The prototypes that were developed acted as sounding boards, revealing what worked, what did not, what had promise, what was realistic given state-of-the-art elements, and when the level of technology allowed a certain feature to be usable in a daily use environment. The author examines the chronology of the program with a special emphasis on broad-scope effects. References to discussions of individual aspects and studies are provided